JP2005528163A - 端部−端部吻合機器およびこれを実施するための方法 - Google Patents
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Abstract
Description
本出願は、「END−TO−END ANASTOMOSIS INSTRUMENT AND METHOD FOR PERFORMING SAME」と題された2002年5月31日に出願された米国特許出願番号10/160,460号に対する利益および優先権を主張する。この内容全体が、本明細書中において参考として援用される。
本開示は、環状本体構造の吻合を実行するための外科用機器および方法に関し、より詳細には、例えば、胃腸手術の間に、管状組織を連結するための機器に関する。
本開示は、胃腸手術の間、第1管腔構造および第2管腔構造(小腸の2つの部分)の端部−端部吻合を実施するための外科用機器に関する。この機器は、アクチュエータが取り付けられたハウジング、およびハウジングの遠位端に取り付けられた選択的取り外し可能装填ユニットを備える。この装填ユニットは、その遠位端において外科用固定具のアレイを支持するような寸法である。アクチュエータの起動の際、外科用固定具は、可動アンビルに対して同時に変形して、その結果、外科用固定具の各々の遠位端が、端部−端部吻合を完了するように各管腔構造の各端部を固定する。理解され得るように、可動アンビルに対する外科用固定具の同時の変形は、有利である。なぜなら、これは、手動の縫合と比較して、全体的な操作時間を大きく減少させ、そしてまた、吻合部位にわたる均一性(これは漏れを減少させる傾向がある)を提供する。
本明細書中に開示される外科用機器および方法の種々の実施形態は、端と端とが接している環状の吻合が、2つの管腔構造(例えば、結腸および/または小腸)の2つの区画を連結することにより形成される、胃腸管手順の観点で記載されている。あるいは、本開示の外科用機器はまた、他の外科手順のために他の管状管腔体構造の端と端とが接している吻合を実施するのに使用され得る。
Claims (20)
- 第1管腔構造および第2管腔構造の端部−端部吻合を実行するための外科用機器であって、以下:
ハウジングであって、アクチュエータが該ハウジングに取り付けられた、ハウジング;
該ハウジングの遠位端に取り付けられた選択的に取り外し可能な装填ユニットであって、該装填ユニットが、その遠位端において外科用固定具のアレイを支持し、該外科用固定具が、該アクチュエータの作動の際に可動アンビルに対して同時に変形可能であり、その結果、変形の際に、該外科用固定具の各々の遠位末端が、該端部−端部吻合を完了するように各管腔構造の各端部を固定する、装填ユニット、
を備える、外科用機器。 - 請求項1に記載の外科用機器であって、前記外科用固定具の各々の遠位端が前記管腔構造の1つの端部の少なくとも1つを貫通する、外科用機器。
- 請求項1または2に記載の外科用機器であって、前記外科用固定具が、前記2つの管腔構造を互いに密接に接触させてしっかりと保持するように、該外科用固定具の変形後、協働する凸部および基部レッグを備える、外科用機器。
- 請求項1〜3のいずれかに記載の外科用機器であって、前記外科用固定具が、基部レッグおよび近位部分を備え、該外科用固定具が、前記装填ユニットを通って延びる長手軸に対する角度様式で支持され、その結果、変形した際に、該外科用固定具の基部レッグが、該外科用固定具の近位部分に対して一定の角度で変形する、外科用機器。
- 請求項1〜4のいずれかに記載の外科用機器であって、前記装填ユニットが、互いに対して旋回可能である2つの半体から構成される、外科用機器。
- 請求項1〜5のいずれかに記載の外科用機器であって、前記装填ユニットの2つの半体が、閉じている場合、細長開口部を形成し、該細長開口部が、該細長開口部を通して前記第1管腔構造を受容する、外科用機器。
- 請求項1〜6のいずれかに記載の外科用機器であって、前記アンカーの作動の前に、前記装填ユニットの2つの半体が、互いに対して旋回可能に固定され、そして前記アクチュエータの作動の際、該2つの半体が、外されて、該半体が、互いに対して旋回し得、前記開口部内から前記第1管腔構造を解除する、外科用機器。
- 請求項1〜7のいずれかに記載の外科用機器であって、前記装填ユニット遠位端が、前記外科用固定具の遠位端を保持し、そして前記第1管腔構造のめくれた端部を支持するためのアンビルを備える、外科用機器。
- 請求項1〜8のいずれかに記載の外科用機器であって、前記アンビルが、角度の付いた表面を備え、該角度の付いた表面によって、前記外科用固定具の遠位端が、発射の間、近位に変形する、外科用機器。
- 請求項1〜9のいずれかに記載の外科用機器であって、前記装填ユニットが、使い捨て可能である、外科用機器。
- 請求項1〜10のいずれかに記載の外科用機器であって、前記装填ユニットの遠位端が、前記外科用固定具を支持するための複数の細長チャネルを備える、外科用機器。
- 請求項1〜11のいずれかに記載の外科用機器であって、前記チャネルの各々が、遠位端および近位端を備え、各チャネルの各遠位端が、各近位端から半径方向にずれており、その結果、前記外科用固定具の近位端および遠位端が、半径方向にずれた様式で支持される、外科用機器。
- 請求項1〜12のいずれかに記載の外科用機器であって、前記外科用固定具が、前記アクチュエータの作動の際に変形可能であり、その結果、各外科用固定具の遠位端が、各管腔構造の各端部を固定して、端部−端部吻合を完了し、ここで、生じるめくれが、該管腔構造の外側である、外科用機器。
- 請求項1〜13のいずれかに記載の外科用機器であって、前記ハンドルが、作動時構成において前記ハンドルをロックするロッキングフランジを備える、外科用機器。
- 請求項1〜14のいずれかに記載の外科用機器であって、前記ロッキングフランジが、二股である、外科用機器。
- 請求項1〜15のいずれかに記載の外科用機器であって、前記アクチュエータが、少なくとも1つのカム部材を備える、外科用機器。
- 請求項1〜16のいずれかに記載の外科用機器であって、前記アクチュエータが、2つのカム従動節を有するカム部材を備え、該カム従動節が、該カム部材内に規定される2つのカムスロットに沿って乗っている、外科用機器。
- 請求項1〜17のいずれかに記載の外科用機器であって、各カム従動節が、それぞれ、第1牽引スリーブおよび第2牽引スリーブを機械的に係合し、その結果、該カム従動節の各々の動きが、それぞれの牽引スリーブを移動させる、外科用機器。
- 請求項1〜18のいずれかに記載の外科用機器であって、前記カムスロットの1つが、2つのカムステージを備え、第1のステージが、前記外科用固定具の変形に対する第1牽引スリーブを受容するためのものであり、そして第2のステージが、第2の牽引スリーブに対して該第1の牽引スリーブを牽引するためのものであり、該選択的に使い捨て可能な装填ユニットの半体を外して、該半体を互いに対して旋回させ得、前記開口部内から該第1の管腔構造を解除する、外科用機器。
- 請求項1〜19のいずれかに記載の外科用機器であって、前記ハウジングが、サムタブを備え、該サムタブが、前記選択的に使い捨て可能な装填ユニットを受容するための第1位置から、前記選択的に使い捨て可能な装填ユニットを固定するための第2位置に移動させ得る、外科用機器。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/160,460 US6769594B2 (en) | 2002-05-31 | 2002-05-31 | End-to-end anastomosis instrument and method for performing same |
PCT/US2003/018295 WO2003101314A1 (en) | 2002-05-31 | 2003-05-30 | End-to-end anastomosis instrument and method for performing same |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
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JP2009161989A Division JP2009219931A (ja) | 2002-05-31 | 2009-07-08 | 端部−端部吻合機器およびこれを実施するための方法 |
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JP2005528163A true JP2005528163A (ja) | 2005-09-22 |
JP2005528163A5 JP2005528163A5 (ja) | 2009-08-27 |
JP4610332B2 JP4610332B2 (ja) | 2011-01-12 |
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JP2004508677A Expired - Fee Related JP4610332B2 (ja) | 2002-05-31 | 2003-05-30 | 端部−端部吻合機器およびこれを実施するための方法 |
JP2009161989A Pending JP2009219931A (ja) | 2002-05-31 | 2009-07-08 | 端部−端部吻合機器およびこれを実施するための方法 |
JP2011236297A Pending JP2012045414A (ja) | 2002-05-31 | 2011-10-27 | 端部−端部吻合機器およびこれを実施するための方法 |
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JP2009161989A Pending JP2009219931A (ja) | 2002-05-31 | 2009-07-08 | 端部−端部吻合機器およびこれを実施するための方法 |
JP2011236297A Pending JP2012045414A (ja) | 2002-05-31 | 2011-10-27 | 端部−端部吻合機器およびこれを実施するための方法 |
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US (5) | US6769594B2 (ja) |
EP (1) | EP1509145A1 (ja) |
JP (3) | JP4610332B2 (ja) |
AU (1) | AU2003245435B2 (ja) |
CA (1) | CA2487832C (ja) |
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US6769594B2 (en) | 2002-05-31 | 2004-08-03 | Tyco Healthcare Group, Lp | End-to-end anastomosis instrument and method for performing same |
AU2003269931A1 (en) | 2002-07-31 | 2004-02-16 | Tyco Heathcare Group, Lp | Tool member cover and cover deployment device |
ES2385522T3 (es) | 2002-10-04 | 2012-07-26 | Tyco Healthcare Group Lp | Dispositivo de grapado quirúrgico |
ES2279231T3 (es) * | 2003-05-09 | 2007-08-16 | Tyco Healthcare Group Lp | Grapa anastomotica con tubo capilar que dispensa fluidos. |
US9060770B2 (en) | 2003-05-20 | 2015-06-23 | Ethicon Endo-Surgery, Inc. | Robotically-driven surgical instrument with E-beam driver |
US20070084897A1 (en) | 2003-05-20 | 2007-04-19 | Shelton Frederick E Iv | Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism |
TWI263552B (en) * | 2003-06-05 | 2006-10-11 | Miyanaga Kk | Core cutter |
US20050010241A1 (en) * | 2003-07-09 | 2005-01-13 | Keith Milliman | Anastomosis instrument and method for performing same |
WO2005079673A2 (en) | 2004-02-13 | 2005-09-01 | Satiety, Inc. | Methods for reducing hollow organ volume |
MXPA06009971A (es) | 2004-02-27 | 2007-08-08 | Satiety Inc | Metodos y dispositivo para reducir volumen de organo hueco. |
WO2005091986A2 (en) * | 2004-03-19 | 2005-10-06 | Tyco Healthcare Group, Lp | Anvil assembly with improved cut ring |
US8181840B2 (en) | 2004-03-19 | 2012-05-22 | Tyco Healthcare Group Lp | Tissue tensioner assembly and approximation mechanism for surgical stapling device |
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US20050087580A1 (en) | 2005-04-28 |
US20110220703A1 (en) | 2011-09-15 |
US20100237129A1 (en) | 2010-09-23 |
US7931183B2 (en) | 2011-04-26 |
US20070062999A1 (en) | 2007-03-22 |
CA2487832C (en) | 2012-04-17 |
EP1509145A1 (en) | 2005-03-02 |
WO2003101314A1 (en) | 2003-12-11 |
JP2009219931A (ja) | 2009-10-01 |
US6769594B2 (en) | 2004-08-03 |
JP4610332B2 (ja) | 2011-01-12 |
CA2487832A1 (en) | 2003-12-11 |
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